Burden, determinants, consequences and care of multimorbidity in rural and urbanising Telangana, India: protocol for a mixed-methods study within the APCAPS cohort

Judith Lieber; Santosh Kumar Banjara; Poppy Alice Carson Mallinson; Hemant Mahajan; Santhi Bhogadi; Srivalli Addanki; Nick Birk; Wenbo Song; Anoop SV Shah; Om Kurmi; Gowri Iyer; Sureshkumar Kamalakannan; Raghu Kishore Galla; Shilpa Sadanand; Teena Dasi; Bharati Kulkarni; Sanjay Kinra

doi:10.1136/bmjopen-2023-073897

Burden, determinants, consequences and care of multimorbidity in rural and urbanising Telangana, India: protocol for a mixed-methods study within the APCAPS cohort

Judith Lieber, Santosh Kumar Banjara, Poppy Alice Carson Mallinson, Hemant Mahajan, Santhi Bhogadi, Srivalli Addanki, Nick Birk, Wenbo Song, Anoop SV Shah, Om Kurmi, Gowri Iyer, Sureshkumar Kamalakannan, Raghu Kishore Galla, Shilpa Sadanand, Teena Dasi, Bharati Kulkarni, Sanjay Kinra

Centre for Healthcare and Communities

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Abstract

Introduction: The epidemiological and demographic transitions are leading to a rising burden of multimorbidity (co-occurrence of two or more chronic conditions) worldwide. Evidence on the burden, determinants, consequences and care of multimorbidity in rural and urbanising India is limited, partly due to a lack of longitudinal and objectively measured data on chronic health conditions. We will conduct a mixed-methods study nested in the prospective Andhra Pradesh Children and Parents' Study (APCAPS) cohort to develop a data resource for understanding the epidemiology of multimorbidity in rural and urbanising India and developing interventions to improve the prevention and care of multimorbidity.

Methods and analysis: We aim to recruit 2100 APCAPS cohort members aged 45+ who have clinical and lifestyle data collected during a previous cohort follow-up (2010-2012). We will screen for locally prevalent non-communicable, infectious and mental health conditions, alongside cognitive impairments, disabilities and frailty, using a combination of self-reported clinical diagnosis, symptom-based questionnaires, physical examinations and biochemical assays. We will conduct in-depth interviews with people with varying multimorbidity clusters, their informal carers and local healthcare providers. Deidentified data will be made available to external researchers.

Ethics and dissemination: The study has received approval from the ethics committees of the National Institute of Nutrition and Indian Institute of Public Health Hyderabad, India and the London School of Hygiene and Tropical Medicine, UK. Meta-data and data collection instruments will be published on the APCAPS website alongside details of existing APCAPS data and the data access process (www.lshtm.ac.uk/research/centres-projects-groups/apcaps).

Original language	English
Article number	e073897
Number of pages	12
Journal	BMJ Open
Volume	13
Issue number	11
DOIs	https://doi.org/10.1136/bmjopen-2023-073897
Publication status	Published - 27 Nov 2023

Bibliographical note

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

Funder

This work was primarily supported by the UK Medical Research Council (MRC) grant number MC_PC_MR/T038292/1. This research was also part funded by MRC grant number MR/V001221/1, the Nagasaki University 'Doctoral Program for World-leading Innovative and Smart Education' for Global Health, KENKYU SHIDO KEIHI and in-kind support from ICMR-NIN.

Funding

This work was primarily supported by the UK Medical Research Council (MRC) grant number MC_PC_MR/T038292/1. This research was also part funded by MRC grant number MR/V001221/1, the Nagasaki University 'Doctoral Program for World-leading Innovative and Smart Education' for Global Health, KENKYU SHIDO KEIHI and in-kind support from ICMR-NIN.

Funders	Funder number
National Institute of Nutrition
Nagasaki University
Medical Research Council	MC_PC_MR/T038292/1, MR/V001221/1

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Cite this

Lieber, J., Banjara, S. K., Mallinson, P. A. C., Mahajan, H., Bhogadi, S., Addanki, S., Birk, N., Song, W., Shah, A. SV., Kurmi, O., Iyer, G., Kamalakannan, S., Kishore Galla, R., Sadanand, S., Dasi, T., Kulkarni, B., & Kinra, S. (2023). Burden, determinants, consequences and care of multimorbidity in rural and urbanising Telangana, India: protocol for a mixed-methods study within the APCAPS cohort. BMJ Open, 13(11), Article e073897. https://doi.org/10.1136/bmjopen-2023-073897

Lieber, J, Banjara, SK, Mallinson, PAC, Mahajan, H, Bhogadi, S, Addanki, S, Birk, N, Song, W, Shah, ASV, Kurmi, O, Iyer, G, Kamalakannan, S, Kishore Galla, R, Sadanand, S, Dasi, T, Kulkarni, B & Kinra, S 2023, 'Burden, determinants, consequences and care of multimorbidity in rural and urbanising Telangana, India: protocol for a mixed-methods study within the APCAPS cohort', BMJ Open, vol. 13, no. 11, e073897. https://doi.org/10.1136/bmjopen-2023-073897

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title = "Burden, determinants, consequences and care of multimorbidity in rural and urbanising Telangana, India: protocol for a mixed-methods study within the APCAPS cohort",

abstract = "Introduction: The epidemiological and demographic transitions are leading to a rising burden of multimorbidity (co-occurrence of two or more chronic conditions) worldwide. Evidence on the burden, determinants, consequences and care of multimorbidity in rural and urbanising India is limited, partly due to a lack of longitudinal and objectively measured data on chronic health conditions. We will conduct a mixed-methods study nested in the prospective Andhra Pradesh Children and Parents' Study (APCAPS) cohort to develop a data resource for understanding the epidemiology of multimorbidity in rural and urbanising India and developing interventions to improve the prevention and care of multimorbidity. Methods and analysis: We aim to recruit 2100 APCAPS cohort members aged 45+ who have clinical and lifestyle data collected during a previous cohort follow-up (2010-2012). We will screen for locally prevalent non-communicable, infectious and mental health conditions, alongside cognitive impairments, disabilities and frailty, using a combination of self-reported clinical diagnosis, symptom-based questionnaires, physical examinations and biochemical assays. We will conduct in-depth interviews with people with varying multimorbidity clusters, their informal carers and local healthcare providers. Deidentified data will be made available to external researchers. Ethics and dissemination: The study has received approval from the ethics committees of the National Institute of Nutrition and Indian Institute of Public Health Hyderabad, India and the London School of Hygiene and Tropical Medicine, UK. Meta-data and data collection instruments will be published on the APCAPS website alongside details of existing APCAPS data and the data access process (www.lshtm.ac.uk/research/centres-projects-groups/apcaps).",

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T2 - protocol for a mixed-methods study within the APCAPS cohort

AU - Lieber, Judith

AU - Banjara, Santosh Kumar

AU - Mallinson, Poppy Alice Carson

AU - Mahajan, Hemant

AU - Bhogadi, Santhi

AU - Addanki, Srivalli

AU - Birk, Nick

AU - Song, Wenbo

AU - Shah, Anoop SV

AU - Kurmi, Om

AU - Iyer, Gowri

AU - Kamalakannan, Sureshkumar

AU - Kishore Galla, Raghu

AU - Sadanand, Shilpa

AU - Dasi, Teena

AU - Kulkarni, Bharati

AU - Kinra, Sanjay

N1 - This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

PY - 2023/11/27

Y1 - 2023/11/27

N2 - Introduction: The epidemiological and demographic transitions are leading to a rising burden of multimorbidity (co-occurrence of two or more chronic conditions) worldwide. Evidence on the burden, determinants, consequences and care of multimorbidity in rural and urbanising India is limited, partly due to a lack of longitudinal and objectively measured data on chronic health conditions. We will conduct a mixed-methods study nested in the prospective Andhra Pradesh Children and Parents' Study (APCAPS) cohort to develop a data resource for understanding the epidemiology of multimorbidity in rural and urbanising India and developing interventions to improve the prevention and care of multimorbidity. Methods and analysis: We aim to recruit 2100 APCAPS cohort members aged 45+ who have clinical and lifestyle data collected during a previous cohort follow-up (2010-2012). We will screen for locally prevalent non-communicable, infectious and mental health conditions, alongside cognitive impairments, disabilities and frailty, using a combination of self-reported clinical diagnosis, symptom-based questionnaires, physical examinations and biochemical assays. We will conduct in-depth interviews with people with varying multimorbidity clusters, their informal carers and local healthcare providers. Deidentified data will be made available to external researchers. Ethics and dissemination: The study has received approval from the ethics committees of the National Institute of Nutrition and Indian Institute of Public Health Hyderabad, India and the London School of Hygiene and Tropical Medicine, UK. Meta-data and data collection instruments will be published on the APCAPS website alongside details of existing APCAPS data and the data access process (www.lshtm.ac.uk/research/centres-projects-groups/apcaps).

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Burden, determinants, consequences and care of multimorbidity in rural and urbanising Telangana, India: protocol for a mixed-methods study within the APCAPS cohort

Abstract

Bibliographical note

Funder

Funding

UN SDGs

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